Posts tagged Scottsdale plastic surgery

Scottsdale – a  report in the journal, Plastic and Reconstructive Surgery, demonstrates that a large number of patients with a history of migraine headaches can achieve elimination and/or reduction in the number of headaches after plastic surgery of the forehead, occipital and temple regions to treat peripheral nerve trigger points.

In the U.S. , nearly 30 million people suffer with migraine headaches that are not aided by standard therapies. Previous studies have demonstrated that peripheral nerve trigger points may increase the number of migraine headaches. Botulinum toxin-A has been shown to reduce and eliminate migraine and other types of headaches. The major theory used to explain these findings is that the toxin deactivates the trigger points. The investigators for this study theorized that surgical intervention of the trigger points may also reduce or eliminate migraine headaches.

The current study is a significant contribution to the plastic surgery literature as it demonstrates the efficacy of independent surgical deactivation of three common migraine headache trigger points through a double-blind, sham surgery, controlled clinical trial. The research included 75 patients with moderate to severe migraine headache who met International Classification of Headache Disorders. The trigger sites were identified (frontal, temporal, and occipital), and patients were randomly assigned to receive either actual or sham surgery on their predominant trigger sites.

A Migraine Disability Assessment, Migraine-Specific Quality of Life, and Medical Outcomes Study 36-Item Short Form Health Survey questionnaires were filled out by patients before treatment and at 1-year after surgery.

The results of the study demonstrate that 15 of 26 patients in the sham surgery group (57.7 %) and 41 of 49 patients in the actual surgery group (83.7 %) experienced at least a 50 percent reduction in migraine headaches. This finding was a statistically significant difference (p < 0.05). In addition, 28 of 49 patients in the actual surgery group (57.1 %) reported complete elimination of migraine headache, compared with only 1 of 26 patients in the sham surgery group (3.8 %). This was also a statistically significant difference (p < 0.001).

The actual surgery group demonstrated statistically significant improvements in all validated migraine headache measurements at 1 year when compared to the sham surgery group. Many of the techniques used in this study resemble and/or are derived from accepted plastic surgery techniques utilized in aesthetic foreheadplasty.  According to the researchers, these improvements were not dependent on the trigger site.

The investigators which were from the Departments of Plastic Surgery and Neurology at Case Western Reserve University in  Cleveland, Ohio concluded that surgical deactivation of peripheral migraine trigger sites is an effective alternative treatment for patients who suffer from frequent moderate to severe migraine headaches that are difficult to manage with standard protocols. A common surgical complication was slight hollowing of the temple in the group with temporal migraine headache.

Patients should know that plastic surgery options for the management of migraine headaches may become more common as a result of this and other supporting research. I personally would not rush into the office of my local plastic surgeon to seek this treatment just yet. Most likely, patients who qualify for this procedure will have to document that they have failed all other forms of therapy before their insurance allows the surgical intervention. On the other hand, a 57 % migraine elimination rate at 1-year follow up is quite impressive and may ultimately turn out to be more cost effective.